VCUHS TELEMEDICINECaring for Inmates with HIV/AIDS
Jane Settle, FNP, MS, RNInfectious Disease Clinic
VCUHS
TOPICSTechnology of TelemedicineVCUHS Telemedicine ProgramValues and Limits of TelemedicineHIV Care for DOC InmatesFollow up Care
EQUIPMENTVideoconferencing SystemHand held cameraStethoscopeComputer terminal
Monitor
Multi-functionprinter/fax/scanner
PC Workstation
PC Workstation
Multi-functionprinter/fax/scanner
Monitor
Switch Switch
ATM/ VPN Link
POTS
DOC Remote site VCUHS Telemedicine center
e Stethoscope
Handheld Camera
e Stethoscope
Polycom
Polycom
VCU Medical Center
VCUHS Telemedicine network sites Virginia Department of Corrections
sites: Augusta CC Bland CC Brunswick CC Buckingham CC Coffeewood CC Deerfield CC Dillwyn CC Fluvana CC Green Rock CC Greensville CC Haynesville CC Indian Creek CC Keen Mountain CC Lawrenceville CC Lunenburg CC Marion CC Mecklenburg CC Nottoway CC
Pocahontas CC Powhattan CC Red Onion state prison St. Brides CC Sussex I state prison Sussex II state prison Wallenridge state prison Virginia Correctional Center for
Women
Outreach Program sites: Rappahannock General Hospital Riverside Tappahannock Hospital Outpatient Telemedicine Clinic in
Tappahannock South Hill Community Memorial
Health Center Virginia Center for Behavioral
Rehabilitation Three Rivers Health District Bay Aging at Colonial Beach
Value of TelemedicineDecreased travelDecreased security issuesCost effectiveAccess to specialty careRegular interaction with nursing and medical
staff who are providing primary careImmediate problem solving
LimitationsDifficult to visualize fine detailDependent on the skills of the person
assisting with exam and presenting information
May see less than whole “picture”
HIV CareAll inmates in DOC identified with HIVServe about 450 inmatesNew patient or follow up careMore than consultant care – we prescribe
HART and order labs (done through VCUHS)Direct the treatment of HIV related
symptoms and infectionsMake recommendations as appropriate
ThemesClinical careImmunizationsDiet and exerciseHIV education and preventionLife issues – substance abuse, mental health,
education, job skills, family issues
Follow up CarePlanning for releaseMedical needs – HIV and otherSeamless transition programHousing and social supportSubstance abuse and mental health issuesVirginia Center for Behavioral Rehabilitation
Bridge Program
Need for improved psychosocial assessment in order to better understand behaviors
Goal (long term) to identify or design services to help individuals engage in medical care and access social support.
Target recently released inmates for detailed assessment and getting neuropsych testing done if needed
Results of Neuropsych TestingHistory of head injuriesDementiaPTSDADHDDepressionAnxietySocial isolation
Client NeedsNavigating social/financial systemsMental health and SA servicesOngoing care for non-HIV related medical
problemsLife skillsFinancial assistance
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